<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Payment Form</title>
    <link rel="stylesheet" href="style2.css">
</head>
<body>
    <div class="h1"><p> PAYMENT FORM</p></div>
    <form action="">
        <div class="container">
            <div class="contact-info">
                <div class="ci"><h2>Contact Information</h2></div>
                <input type="text" name="name" placeholder="Name" required>
                
                   
                    <p><input type="radio" name="gender" id="male" required>Male</p>
                    <p><input type="radio" name="gender" id="female" required>Female</p>
                    
                
                <textarea name="address" id="address" cols="39" rows="6" placeholder="Adderss"></textarea>
                <input type="email" name="email" id="email" placeholder="Email" required>
                <input type="number" name="pincode" id="pincode" placeholder="Pincode" required>
            </div>
            
            
    
            <div class="payment-info">
                <div class="pi"><h2>Payment Information</h2></div>
                
                    <select name="card_type" id="card_type" required>
                        <option value="">--Select a Card Type--</option>
                        <option value="visa">Visa</option>
                        <option value="mastercard">Mastercard</option>
                        <option value="rupay">Rupay</option>
                    </select>
                
                <input type="number" name="card_number" id="card_number" placeholder="Card Number" required>
                <p>Expiry Date:</p>
                 <input type="date" name="expiry_date" id="expiry_date" placeholder="Expiration date" required>
                
                <input type="password" name="cvv" id="cvv" placeholder="cvv" required>
                
    
            </div>
        </div>
        
        <div class="submit"><input type="submit" value="Pay Now"></div>
        
    </form>
</body>
</html>